title: Evaluation of serogroup C and ACWY meningococcal vaccine programs: projected impact on disease burden according to a stochastic two-strain dynamic model.
abstract: OBJECTIVE
  Advisory committees in Canada and the United States have updated recommendations for quadrivalent meningococcal conjugate vaccines against serogroups A, C, W135, and Y. Our objective was to evaluate optimally effective meningococcal vaccination policies using a stochastic dynamic model. Canada was used as an example.
  
  
  METHODS
  Our stochastic dynamic model of Neisseria meningitidis (Nm) transmission in an age-structured population assumed partial cross-immunity among two aggregated serogroup categories: 'AWY' containing A, W135, and Y; and 'Other' containing B, C, and ungroupable types. We compared the impact of monovalent C versus quadrivalent ACWY vaccination on Nm carriage and invasive meningococcal disease (IMD). Our model was parameterized with Canadian epidemiological and demographic data and employed probabilistic sensitivity analysis.
  
  
  RESULTS
  Routine infant immunization at 12 months and boosting at 15 years with a quadrivalent vaccine is projected to have the largest impact on total IMD incidence: a 74% reduction over 40 years. Routine infant immunization with a monovalent vaccine at 12 months only has much less impact and also generates strain replacement appearing after approximately ten years of continuous use.
  
  
  CONCLUSIONS
  Immunizing infants at 12 months and boosting adolescents at 15 years with an ACWY vaccine is predicted to be most effective at reducing IMD incidence.
authors.affiliation: Computational Epidemiology and Public Health Laboratory, University of Saskatchewan, Saskatoon S7N 5C9, Canada; Pythagoras Consulting, Guelph N1H 2L3, Canada.
authors.forename: David M
authors.initials: DM
authors.lastname: Vickers
authors.affiliation: GlaxoSmithKline Vaccines, 1300 Wavre, Belgium; Abbott Laboratories, Diagnostics Division, Abbott Park, IL 60064, USA.
authors.forename: Andrea M
authors.initials: AM
authors.lastname: Anonychuk
authors.affiliation: Department of Social and Preventive Medicine, Laval University, Quebec City G1V 0A6, Canada.
authors.forename: Philippe
authors.initials: P
authors.lastname: De Wals
authors.affiliation: GlaxoSmithKline Vaccines, 1300 Wavre, Belgium.
authors.forename: Nadia
authors.initials: N
authors.lastname: Demarteau
authors.affiliation: Pythagoras Consulting, Guelph N1H 2L3, Canada; Department of Mathematics and Statistics, University of Guelph, Guelph N1G 2W1, Canada; Department of Applied Mathematics, University of Waterloo, Waterloo N2L 3G1, Canada. Electronic address: cbauch@uwaterloo.ca.
authors.forename: Chris T
authors.initials: CT
authors.lastname: Bauch
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016470:Bacteremia / Q000453:epidemiology / Q000382:microbiology / Q000517:prevention & control; D002170:Canada / Q000453:epidemiology; D002675:Child, Preschool; D005260:Female; D006801:Humans; D017589:Immunization Programs; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D016920:Meningitis, Bacterial / Q000453:epidemiology / Q000382:microbiology / Q000517:prevention & control; D008589:Meningococcal Infections / Q000453:epidemiology* / Q000382:microbiology / Q000517:prevention & control*; D022401:Meningococcal Vaccines / Q000008:administration & dosage* / Q000276:immunology*; D008875:Middle Aged; D015233:Models, Statistical; D009345:Neisseria meningitidis / Q000145:classification / Q000302:isolation & purification*; D065288:Serogroup; D055815:Young Adult
chemical_list: D022401:Meningococcal Vaccines
keywords: Dynamic model; Immunization programs; Invasive meningococcal disease; Meningococcal vaccines; Neisseria meningitidis; Stochastic model; Strain replacement